IT governance is all about eliminating the ‘muda’

The chief privacy officer of Toronto’s Sunnybrook Health Sciences Centre explains how a recent clinical management system was an opportunity to demonstrate the value of using an ISACA framework


Muda is a Japanese word that loosely translates to “futility” or “useless tasks.” And in the corporate world, there’s an awful lot of muda, particularly when it comes to IT.

How much time and money has been spent on projects that never get off the ground or don’t meet their objectives? That’s certainly been the case in healthcare — whatever happened to the billions of dollars spent on developing a national e-health initiative? Muda.

That’s why IT governance is so important — to have a roadmap of where you’re going, how you’re going to get there and how to measure whether or not you’re meeting those goals.

So when it came time for Toronto’s Sunnybrook Health Sciences Centre to roll out a new clinical management system, IT governance was front and centre. Sunnybrook, which recently refreshed its IT strategy, is one year into a three-year rollout of its SunnyCARE Clinical Management System, using ISACA’s IT governance framework to support the measurement and management of IT performance.

One of the drivers behind the project was a lack of visibility into value and risk, said Jeff Curtis, Sunnybrook’s chief privacy officer, who spoke at a seminar last month in Toronto on IT governance sponsored by CIPS and ISACA.

The vision is to integrate clinician work under a single app, available on a mobile device at the patient’s bedside. This isn’t as easy as it might sound: The centre has more than 90 types of clinical management systems.

And that results in what Curtis calls “physician muda.” A single patient visit involved a total of 19 steps, which obviously resulted in a lot of wasted time and effort, doing repetitive, non-value-added tasks (or muda).

With its IT governance strategy, Sunnybrook expects to save 30 to 40 per cent of a physician’s time by integrating these clinical management systems — from emergency room flow to allergy information to pre-admission needs (which can be measured using scorecards).

As a result, physicians might be able to see more patients or spend more meaningful time with them. It’s still a work in progress, but it’s being measured, managed and adjusted along the way.

If you’re wondering why this whole IT governance thing is so important, let’s take a step back. Remember Canada Health Infoway? The idea was to create a national electronic health system, linking the nation’s health care professionals, pharmacists and doctors with hundreds of hospitals, thousands of clinics and every Canadian citizen.

It’s still not entirely clear how much money was poured into this over the years — the feds spent more than $2 billion over the past decade, but that doesn’t include what the provinces invested. Problem is, the benefits aren’t tangible either. If you’ve had any experience in a clinic or hospital lately, I probably don’t need to explain my point further.

For organizations experiencing muda (and that’s probably most of them), what needs to be done? Find a standards-based IT governance framework (there are several out there, such as the one from ISACA) and then engage senior leadership — giving them tangible business benefits that can be measured, managed and adjusted along the way.

Senior execs may not understand the inner workings of a corporate network, but you can bet they’ll understand the concept of muda.

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